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癌症丧亲与老年配偶的抑郁症状:昼夜节律睡眠-觉醒周期的可能调节作用。

Cancer Bereavement and Depression Symptoms in Older Spouses: The Possible Modifying Role of the Circadian Rest-Activity Rhythm.

机构信息

Department of Psychiatry, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.

Department of Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.

出版信息

Clin Gerontol. 2021 Mar-Apr;44(2):126-132. doi: 10.1080/07317115.2020.1812787. Epub 2020 Aug 28.

Abstract

OBJECTIVES

This study examines the associations of cancer death and aspects of the 24-h circadian rest-activity rhythm (RAR) on depression symptoms in older spouses.

METHODS

Participants included 46 adults aged 60-94 years ( = 73 years) who experienced the death of a spouse. We tested a multivariate model using cancer death (vs. non-cancer death) and RAR variables as correlates of depression symptoms while controlling for age, sex, physical illness burden, and preparedness for death. We also present a case example to describe the behavioral activity patterns of a participant bereaved by cancer.

RESULTS

Cancer death was associated with elevated levels of depression symptoms. However, the timing of the RAR moderated this association. Cancer bereavement was associated with depression symptoms when participants "settled-down" after 11:00 PM. The case example illustrates how intrusive thoughts about death quality impacts a widower's drive to stay busy with daily activities.

CONCLUSIONS

Settling down earlier in the evening is important for older spouses bereaved by cancer, in terms of fewer symptoms of depression.

CLINICAL IMPLICATIONS

Objectively specifying the activity patterns of older spouses bereaved by cancer is a promising avenue for interventions that aim to reduce depression symptoms.

摘要

目的

本研究考察了癌症死亡与 24 小时昼夜节律(RAR)的各个方面与老年配偶抑郁症状之间的关联。

方法

参与者包括 46 名年龄在 60-94 岁(= 73 岁)之间的成年人,他们经历了配偶的死亡。我们测试了一个多变量模型,使用癌症死亡(与非癌症死亡)和 RAR 变量作为抑郁症状的相关因素,同时控制年龄、性别、身体疾病负担和对死亡的准备情况。我们还提供了一个案例示例,描述了一位因癌症而丧偶的参与者的行为活动模式。

结果

癌症死亡与抑郁症状水平升高有关。然而,RAR 的时间安排调节了这种关联。当参与者在晚上 11 点以后“安顿下来”时,癌症丧亲与抑郁症状有关。案例示例说明了关于死亡质量的侵入性想法如何影响鳏夫保持日常活动忙碌的动力。

结论

对于因癌症而丧偶的老年配偶来说,晚上早些时间安定下来对于减少抑郁症状很重要。

临床意义

客观描述因癌症而丧偶的老年配偶的活动模式是一种很有前途的干预途径,旨在减少抑郁症状。

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本文引用的文献

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Postgrad Med J. 2018 Nov;94(1117):653-658. doi: 10.1136/postgradmedj-2018-135719. Epub 2018 Dec 6.
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Spousal Bereavement Following Cancer Death.癌症死亡后的配偶丧亲之痛。
Illn Crises Loss. 2013;21(3):185-202. doi: 10.2190/IL.21.3.b.
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Preventing depression: a global priority.预防抑郁症:全球优先事项。
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